Ethics

Recent furor around research on the H5N1 virus strain that has caused influenza in birds and rare cases of severe influenza in people may have died down for the time being after last week’s meeting of a group of experts assembled by the World Health Organization. They recommended that two different groups involved in what has come to be seen as controversial research should publish their findings in full. A halt on the bird flu research in question and publication of those data is still in place, however, and will likely last a few months longer.

To date, this H5N1 virus is not efficiently transmissible among humans – in fact, humans generally have been infected only after close contact with infected poultry. But virologist Ron Fouchier at Erasmus Medical Center in Rotterdam manipulated the virus so that it became easily transmissible between ferrets via airborne droplets. (Ferrets are a useful standin for humans in influenza studies.) A team headed by Yoshihiro Kawaoka at the University of Madison-Wisconsin accomplished similar results: both papers were under review for publication by science journals before the controversy developed. More

At the University of Pennsylvania School of Medicine on May 14, Arthur L. Caplan, PhD, Emmanuel and Robert Hart Director of the Center for Bioethics and the Sydney D. Caplan Professor of Bioethics at the University of Pennsylvania, gave a talk entitled “Ethical Lessons of Swine Vaccine Rationing.” Caplan, a widely quoted voice in bioethics, noted that the 2009 H1N1 pandemic provided testing ground for pandemic and even bioterror response planning. What can we learn from the experience?

Caplan described several areas for improvement. First, he noted the plethora of plans, developed at different levels of authority, for dealing with the pandemic. Hospitals, corporations, cities, and states developed plans with different priorities and rationales, some of them potentially at odds. Caplan highlighted the conflict between, for example, a state that might decide to quarantine itself to attempt to reduce importation of disease and a vaccine manufacturer in that state with a need to distribute its product. Would the state plan necessarily take the manufacturer’s needs into account? More